Successful treatment of degenerative medial meniscal tears in well-alignedss knees with fibrin clot implantation

  • Hiroshi NakayamaEmail author
  • Ryo Kanto
  • Shunichiro Kambara
  • Tomoya Iseki
  • Shintaro Onishi
  • Shinichi Yoshiya



The purpose of this study was to examine the results of meniscal repair performed for symptomatic degenerative medial meniscal tears.


Twenty-four knees in 24 patients with symptomatic degenerative medial meniscal tears (mostly complex horizontal tears) who underwent isolated arthroscopic repair combined with autologous fibrin clot implantation were included in this study. The patients were followed up for a minimum of 2 years. The overall clinical outcome was evaluated using the Lysholm score, while the activity level was graded on the Tegner Activity Scale. The assessment of healing status at the repair site was based on clinical signs/symptoms and follow-up MRI examination results. In addition, the effects of the patient’s clinical and radiological factors on healing of the repaired menisci were analyzed.


The mean age of the study subjects was 47.0 ± 8.1 years with a mean follow-up period of 39.3 ± 11.6 months. The Lysholm score significantly improved after surgery (P < 0.01). During the follow-up period, meniscal repairs were deemed to have failed in 6 of the 24 knees (25%). In the analysis of factors influencing meniscal healing, varus deformity (% of mechanical axis < 30%) was identified in all knees in the repair failure group, and the presence of varus deformity was shown to be a significant risk factor correlated with repair failure, while other factors did not significantly influence the healing status.


The short-term follow-up results showed that arthroscopic repair of degenerative medial meniscal tears combined with fibrin clot implantation attained clinical healing in 18 of 24 knees (75%) of patients, while 6 of the 24 knees (25%) of patients experienced clinical failure. The presence of varus deformity negatively affects the healing rate. In well-aligned knees, degenerative medial meniscal tears are successfully treated by isolated repair with fibrin clot implantation.

Level of evidence



Medial meniscus Degenerative tear Fibrin clot Meniscal repair Varus Varus alignment 



No external source of funding was used.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019

Authors and Affiliations

  • Hiroshi Nakayama
    • 1
    Email author
  • Ryo Kanto
    • 1
  • Shunichiro Kambara
    • 1
  • Tomoya Iseki
    • 1
  • Shintaro Onishi
    • 1
  • Shinichi Yoshiya
    • 1
  1. 1.Department of Orthopaedic SurgeryHyogo College of MedicineNishinomiya CityJapan

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